JEFFERSON CITY, Mo. -- Couching it as a life or death issue, about 200 disabled people and advocates rallied Tuesday at the Capitol to urge Gov. Bob Holden to delay a Medicaid change that would force them to spend more of their own money on health care.

One woman said concerns about the change led her ex-husband to commit suicide. Others said they understood his desperation.

Still others at the rally said they might have to sell their houses and move into nursing homes because of the change, scheduled to take effect Oct. 1.

But there was little chance the rally would accomplish its desired result.

"The governor is very concerned about their situation," said Holden spokesman Mary Still. But "there's no opportunity to fund anything extra."

Missouri's $18.9 billion budget assumes about $16.5 million in savings in state and federal money by changing the so-called "spend-down" portion of its Medicaid program.

To qualify for Medicaid, most Missourians can have incomes equal to no more than 77 percent of the federal poverty level -- around $545 monthly for an individual.

But the spend-down provision has allowed those with higher incomes to participate in Medicaid if their medical expenses lower their available income to the eligibility threshold.

For years, Medicaid has picked up the entire bill if a person incurs enough medical expenses in one day to qualify for the program.

But the change will require people to spend their own money each month. Medicaid then will pay for any additional medical expenses, but not the previous ones.

'Too much to worry about'

When Daniel Gillam learned of the change, he became consumed with worries about paying for his health care, said his ex-wife Joanie Gillam of Viburnum, who was providing his daily care.

Daniel Gillam stabbed himself to death in a bathtub on June 21, Joanie Gillam said.

"I lost a best friend, and I lost a life partner," she said. "I truly think this change in this policy ... gave him too much to worry about."